CHOICES Frequently Asked Questions

Below are some frequently asked questions about CHOICES.

What makes CHOICES unique?

CHOICES prevents alcohol-exposed pregnancies by working with women who are drinking at risky levels and who may become pregnant. CHOICES is unique in several ways:

  • It focuses on the period before women become pregnant. Women may not know that they are pregnant until well into the first trimester (first three months of pregnancy). Therefore, if they are drinking, harm to their baby may have already occurred.
  • It uses a dual-focused approach that addresses both alcohol use and contraception.

Who is eligible for CHOICES?

CHOICES is for women 18-44 years old who are:

  • Drinking alcohol at risky levels
    • more than three drinks (or four or more) on an occasion, and/or
    • more than seven drinks in a week
  • Able to become pregnant (no hysterectomy, menopause, sterilization, etc.)
  • Not trying to get pregnant
  • Not using contraception at all or in a way that effectively prevents pregnancy

Can CHOICES be used with women who are pregnant or trying to become pregnant?

No. Women who are pregnant or trying to get pregnant are advised that there is no known safe level of drinking during pregnancy. There are other interventions to help pregnant women stop drinking.

Is the family planning visit essential?

Yes. The program gives women a choice between reducing or stopping drinking and/or using effective contraception to reduce their risk for an alcohol-exposed pregnancy. It is essential that contraceptive services be made available for women participating in the program. Clinics without on-site contraceptive care services can link with external providers.

Can CHOICES be used with teens?

Although it was not tested with teens younger than age 18, some programs are doing so. Some key considerations are:

  • Your program’s guidelines about discussing alcohol use with underage females
  • Sexual relations between underage teens and older boys or men may be a reportable crime in your state.

You need to:

  • Know your reporting responsibilities
  • Inform clients of your need to report sexual or drinking behavior

How can I implement CHOICES when some healthcare providers in my community tell their patients it is “okay” to drink during pregnancy?

The message that it is “okay” to drink during pregnancy is one that you will need to address through education of providers in your community. Communicate to them that the U.S. Surgeon General and major health professional associations, such as the American College of Obstetricians and Gynecologists, state that women should not drink alcohol at any time while pregnant. Make sure that your family planning referral source is up-to-date on these issues and will support the messages given through the CHOICES program.